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Allopurinol is a medication used to decrease high blood uric acid levels. [5] It is specifically used to prevent gout , prevent specific types of kidney stones and for the high uric acid levels that can occur with chemotherapy .
According to the American College of Rheumatology guidelines, allopurinol is the first-line medication for lowering uric acid levels. Febuxostat is another uric acid-lowering medication that may ...
Allopurinol blocks uric acid production, and is the most commonly used agent. [20] Long term therapy is safe and well-tolerated and can be used in people with renal impairment or urate stones, although hypersensitivity occurs in a small number of individuals. [20]
Drugs with other primary uses, that have known uricosuric properties, include losartan, [1] atorvastatin, and fenofibrate.Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk.
Mycophenolate mofetil is an immunosuppressant drug used to prevent rejection in organ transplantation; it inhibits purine synthesis by blocking inosine monophosphate dehydrogenase (IMPDH). [5] Methotrexate also indirectly inhibits purine synthesis by blocking the metabolism of folic acid (it is an inhibitor of the dihydrofolate reductase ).
Because xanthine oxidase is a metabolic pathway for uric acid formation, the xanthine oxidase inhibitor allopurinol is used in the treatment of gout. Since xanthine oxidase is involved in the metabolism of 6-mercaptopurine, caution should be taken before administering allopurinol and 6-mercaptopurine, or its prodrug azathioprine, in conjunction.
Lesinurad is used in combination with a xanthine oxidase inhibitor, such as allopurinol or febuxostat, for treating hyperuricemia (high levels of uric acid in the blood serum) associated with gout. It is approved only for patients who have not achieved target uric acid levels with a xanthine oxidase inhibitor alone. [2]
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